Antipsychotics cardiotoxicity: What's known and what's next

Table 1 Six autopsy-based studies assessing demographic and forensic characteristics of sudden unexplained deaths after antipsychotic use

Category	Sweeting et al[7]	Ifteni et al[75]	Sun et al[58]	Ye et al[40]	Jusic and Lader[74]	Manu et al[73]
Publication year	2013	2014	2019	2018	1994	2011
Case region	Sydney, Australia	Brasov, Romania	MD, United States	Shanghai, China	London, United Kingdom	New York, United States
Reported case number	72/683	6/57	11/391	5/24	8 case reports	52/100
Age, yr (mean ± SD)	53 ± 14	55 ± 13	36 ± 17	57 ± 5	36 ± 14	50 ± 13
Males, n (%)	41 (56.9)	4 (66.7)	7 (63.6)	1 (20.0)	5 (62.5)	31 (59.6)
BMI (kg/m2)	26.0 ± 7.1	26.0 ± 4.8	31.0 ± 7.2	NA	NA	NA
Autopsy finding1, n (%)	NA					NA
Mild atherosclerosis		3 (50.0)	0 (0.0)	0 (0.0)	0 (0.0)
Chronic pericarditis		1 (16.7)	0 (0.0)	0 (0.0)	0 (0.0)
Myocardial dystrophy or fibrosis		1 (16.7)	2 (18.2)	0 (0.0)	1 (12.5)
Ventricular dilation		0 (0.0)	2 (18.2)	0 (0.0)	0 (0.0)
Cardiomegaly		0 (0.0)	2 (18.2)	0 (0.0)	0 (0.0)
Conduction system abnormality		0 (0.0)	0 (0.0)	2 (40.0)	0 (0.0)
Lung edema, congestion		1 (16.7)	0 (0.0)	0 (0.0)	4 (50.0)
None		0 (0.0)	5 (45.5)	3 (60.0)	4 (50.0)
Postmortem toxicology1, n (%)	NA	NA
First-generation						4 (7.7)
Chlorpromazine			0 (0.0)	2 (40.0)	5 (62.5)
Haloperidol			0 (0.0)	1 (25.0)	5 (62.5)
Thioridazine			0 (0.0)	0 (0.0)	1 (12.5)
Droperidol			0 (0.0)	0 (0.0)	2 (25.0)
Promazine			0 (0.0)	0 (0.0)	1 (12.5)
Trifluoperazine			0 (0.0)	0 (0.0)	1 (12.5)
Pimozide			0 (0.0)	0 (0.0)	2 (25.0)
Fluphenazine			0 (0.0)	0 (0.0)	2 (25.0)
Second-generation
Olanzapine			0 (0.0)	2 (40.0)	0 (0.0)	2 (3.8)
Quetiapine			4 (36.4)	1 (25.0)	0 (0.0)	11 (21.2)
Clozapine			2 (18.2)	1 (25.0)	0 (0.0)	5 (9.6)
Risperidone			0 (0.0)	0 (0.0)	0 (0.0)	4 (7.7)
Ziprasidone			0 (0.0)	0 (0.0)	0 (0.0)	1 (1.9)
Negative			5 (45.5)	0 (0.0)	0 (0.0)	0 (0.0)

¹Some cases are presented with ≥ 2 autopsy findings or drugs, so the sum may exceed the total number of columns. BMI: Body mass index; NA: Not available.